Aging and Disability Resource Centers: The Natural Evolution for I

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Aging and Disability Resource Centers The
Natural Evolution for I R/A
Aging in America 2008 Annual Conference of
NCOA and ASA March 29, 2008
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Aging and Disability Resource Centers Evolution
of I R/A

• Presenters
• Greg Case, U.S. Administration on Aging
• Bernice Hutchinson, National Association of State
  Units on Aging
• Stephanie Hull, Maryland Department of Aging

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Aging and Disability Resource Centers

• Session Premise
• Aging and Disability Network and other human
  services IR/A systems are the foundation of an
  effective ADRC

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From IR to ADRC A Solid FoundationHistorical
Context, Philosophy, Structural Framework and
Evolution

• Bernice Hutchinson
• National Aging Information and Referral Support
  Center
• National Association of State Units on Aging

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Historical Contextmulta bene facta many things
done well

• Legislative Mandate The Older Americans Act
• National Policy Statement, Infrastructure for
  Systems Design and Service Delivery
• Commitment Administration on Aging
• National Vision and Mission, Ongoing Investment
• Presence The Aging Network
• Gateway to Information, Dedicated Staff,
  Advocacy
• Expectations Consumers
• Point in time support, caregiver needs, future
  planning

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Philosophical Groundinga solid template

• Independence
• Advocacy
• Quality
• Quantitative Scale

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Structural Frameworkcommanding reach and impact

• The Aging Network
• Older Americans Act IR System
• Link to Supportive Services
• Connection to Skilled Advocates

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History and Evolutiondeveloping gateways to
aging services

• 1970s
• OAA, Standards, AIRS and AoA Guide
• 1980s
• Studies, State Models and Definitive Literature
• 1990s
• National Initiative, GAO Report, Performance
  Based Competencies, Certification, Vision 2010
• 2000 and beyond
• 211, ADRC Grantees, 2006 Aging IR Survey

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Evolution of the Landscapeparadigm shift,
watershed period

• Vision 2010
• Boomer Planning
• Diversity
• Emergency Preparedness
• Medicare Part D
• Health and Wellness
• Community Living

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Aging and Disability Resource Centers

• VISION
• To have Resource Centers available to every
  community across the country serving has highly
  visible and trusted sources where people of all
  ages, incomes and disabilities can turn for
  information on the full range of long-term
  support options and a single point of entry to
  public long-term supports programs and benefits.
  

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Aging and Disability Resource Centers

• Awareness Information
• Public Education
• Information on Options
• Assistance
• Options Counseling
• Benefits Counseling
• Employment Options Counseling
• Referral
• Crisis Intervention
• Planning for Future Needs
• Access
• Eligibility Screening
• Private Pay Services
• Comprehensive Assessment
• Programmatic Eligibility Determination
• Medicaid Financial Eligibility Determination
• One-Stop Access to all public programs

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Aging and Disability Resource Centers

• Existing IR/A systems
• The foundation of an effective ADRC
• ADRC INITIATIVE
• Encourages greater use of Information Technology
  simplifying systems and improving access for
  consumers
• Integrated MIS systems reducing duplication
• Web-based consumer self-assessment and care
  planning tools
• On-line applications for services

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IT/MIS Enhancements by ADRCs March 2008
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Aging and Disability Resource Centers

• Existing IR/A systems
• The foundation of an effective ADRC
• ADRC INITIATIVE
• Transitions assistance to long-term care
  options counseling

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Aging and Disability Resource Centers

• Long-Term Care Options Counseling Definition
• An interactive decision-support process whereby
  consumers, family members and/or significant
  others are supported in their deliberations to
  determine appropriate long-term care choices in
  the context of the consumers needs, preferences,
  values and individual circumstances.

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Aging and Disability Resource Centers

• When Might Options Counseling Happen?
• When an individual has immediate or short range
  long-term care needs
• After admission to a long-term care facility
• When a family caregiver needs help to continue
  providing care
• When a long distance caregiver has concerns about
  the increased frailty or care needs of a loved
  one

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Aging and Disability Resource Centers

• Existing IR/A systems
• The foundation of an effective ADRC
• ADRC INITIATIVE
• Integrates programs and systems and creates
  seamless access to long-term supports and
  services
• Co-location of staff across multiple programs
• MOUs and formal coordination
• Formal linkages and interventions with critical
  pathways

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Streamlining Access Improving Consumer Ease of
Access November 2007n 24 grantees, 81 open
pilot sites
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Streamlining Access Improving Efficiency/Timelin
ess November 2007n 24 grantees, 81 open
pilot sites
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Aging and Disability Resource Centers

• Existing IR/A systems
• The foundation of an effective ADRC
• ADRC INITIATIVE
• Expands existing partnerships between aging,
  disability and other human services networks to
  enhance long term support and services systems
• Forges stronger partnerships between aging and
  disability networks
• Sharing of resources across organizations for
  maximum benefit
• Leveraging expertise across networks and systems

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ADRC Partnerships November 2007
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Partnership Turning Challenges into
Opportunities

• ADRC Challenges ADRC Opportunities
• Whats in it for me? ADRC can help free up
  staff and resources to
• focus on other core functions and priorities
• We dont do it that way! Culture Shift
  Stepping outside of a silo and collaborating
  provides an agency the opportunity
• to improve service provision
• We dont have funds for MIS. Provides
  resources for multiple partners to update
• and/or have access to an I R system
• They dont have experience Cross training
  allows professionals to step outside
• serving our population. of their silos and
  understand the system holistically
• as well as another providers point of views

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MassachusettsAging Disability Resource
Consortium

• Equal partnership between Independent Living
  Centers (ILCs) and Aging Service Access Points
  (ASAPs)
• Agencies retain own autonomy, yet strengthen
  community presence through collaboration
• Existing functions across the two organizations
  are coordinated and streamlined to better serve
  consumers
• Cross-training of ASAP and ILC staff to enhance
  service delivery

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Partnerships to Enhance Services and Systems

• CMS Senior Risk Reduction Demonstration
• Demonstrating the role of the ADRC in assisting
  older adults to make necessary lifestyle
  adjustments to reduce their risk for disease and
  disability.
• Reverse Mortgage Counseling
• Demonstrating the value of providing financial
  counseling for HUD Home Equity Conversion
  Mortgages through ADRC as part of their aging in
  place options counseling.

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Partnerships to Enhance Services and Systems

• Collaboration with 2-1-1 Systems
• Demonstrating new efficiencies through
  co-location of staff, shared resource databases,
  using 2-1-1 as the entry point to ADRCs, and the
  use of referral protocols and MOUs.

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ADRC Technical Assistance

• Technical Assistance Resources
• Website
• Resource Materials (e.g. Issue Briefs)
• National Meetings
• Weekly Electronic Newsletters
• Surveys of grantees
• TA Tracking Tool Reports
• Building a Grantee Online Community
• Monthly Teleconferences/Web casts
• Bi-monthly Workgroup Teleconferences
• On-line Discussions
• Electronic Bulletin Board

Reinforced Learning Process
www.adrc-tae.org
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Maryland Access Point

• Building on Information and Assistance in Area
  Agencies on Aging (AAAs) and Centers for
  Independent Living (CILs)

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Background

• Maryland has four Aging and Disability Resource
  Centers aka Maryland Access Points (MAP)
• Three are housed in Area Agencies on Aging (AAA)
  and one is housed in a local Health Department
• Two are suburban sites, one is rural, and one is
  rural/suburban
• Marylands goal is to have MAP sites in all
  counties or regions
• New sites may be AAAs, Health Departments, Local
  Departments of Social Services, or Centers for
  Independent Living or their equivalent

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Building on Information and Assistance
Infrastructures

• Information and Assistance is a bedrock of
  every MAP
• The method of building on the Information and
  Assistance infrastructures in the aging network
  and the disability network has differed in each
  MAP
• The AAAs have basically realigned their previous
  IA staff into the MAP and expanded I A staff
  expertise to include options counseling and
  assistance for non-elderly populations with
  disabilities
• The Health Department has co-located Commission
  on Aging I A staff at the MAP and hired an
  Intake Worker that functions as an I A worker

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Center for Independent Living Information and
Assistance in MAP

• Washington County is developing an integrated
  model through
• the co-location of CIL staff with IA staff at
  the MAP and
• Creation of a shared database among the AAA and
  CIL and other critical pathways
• This model requires close collaboration between
  the CIL and the MAP on operations and philosophies

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From Information and Assistance to Options
Counseling

• All Maryland MAP sites are providing training and
  certifications that expand the I A function
  toward options counseling for all adult
  populations requesting long-term care services or
  counseling
• Maryland does not have an agreed upon definition
  of options counseling
• It generally means moving from referral
  assistance toward actual interviews where an
  individuals questions and situation are explored
  and a variety of options are offered prior to
  providing actual assistance
• This sometimes results in direct assistance with
  applications for program services and it
  sometimes results in referrals

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Howard County MAP

• Suburban County AAA
• Began with six I A staff and now has 12 staff
  through consolidation of staff from the Senior
  Health and Information Program, the Caregiver
  Program, and new MAP staff including the Manager,
  a bi-lingual counselor, and a part-time data
  manager
• On-going training is provided to develop options
  counseling and to have all staff certified by
  AIRS
• Special arrangement with County Disabilities
  Services Organization
• Provides short-term case management and has added
  two new interim case managers this year using
  county funding

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Worcester County MAP

• Rural County Health Department
• Co-located local health department nurses,
  Commission on Aging I A and Senior Care staff,
  and Department of Social Services service Staff
• Implemented a universal intake form
• Conducts regular cross-training for staff
• Hired MAP manager and Intake Coordinator
• Works with Regional CIL for referrals and
  consultation and as a member of the Advisory
  Board
• Provides referrals, options counseling, and
  short-term case management

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Washington County MAP

• New rural/suburban AAA
• Realigned six I A staff, integrated SHIP staff,
  co-located CIL staff, and hired a MAP manager and
  Information Specialist
• Options counseling and short-term case management
  is directed toward a social worker and
  Information Specialist
• Training for front line workers to move from
  referral to options counseling
• Cross training and shared data base development

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Anne Arundel County MAP

• Suburban county AAA (in start-up)
• Realigned six I A staff and added a seventh
  position to coordinate the MAP
• Cross training is planned
• The I A staff have been moving toward options
  counseling prior to the realignment
• Umbrella organization includes disabilities
  services

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Summary of MAP Sites
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Next Steps in Maryland

• Agreeing on an operational definition of options
  counseling and a method to measure its
  implementation and effectiveness
• Integrating the CIL concept of options counseling
  with the AAA concept